Bush's Flu Plan Stresses Vaccine

He wants to stockpile drugs before a lethal strain develops and spreads worldwide. Some of his goals are unreachable until 2010.

WASHINGTON — Preparing for the possibility of a devastating flu pandemic, President Bush outlined a $7.1-billion plan Tuesday to provide enough vaccine for the nation and to create stockpiles of drugs to treat those who become infected.

"There is no pandemic flu in our country, or in the world, at this time," Bush said in a speech at the National Institutes of Health. "But if we wait for a pandemic to appear, it will be too late to prepare and ... many lives could be needlessly lost."

Public health experts said it was only a matter of time before a super-flu developed with the potential to spread around the globe and kill millions of people.

Pandemics occur when a viral strain to which humans have no immunity mutates and becomes easily transmissible from person to person. Such viruses commonly appear first among birds, and scientists are closely tracking an especially virulent strain -- called H5N1 -- first identified in China in 1996. That strain has killed 62 people.

For The Record Los Angeles Times Thursday November 03, 2005 Home Edition Main News Part A Page 2 National Desk 1 inches; 48 words Type of Material: Correction Flu plan -- An article in Wednesday's Section A about President Bush's flu pandemic preparations said the plan would not begin until 2010. In fact, the capability to vaccinate the entire U.S. population would not be available until 2010, but other elements of the plan take effect immediately.

Some elements of Bush's plan, which would not begin until 2010, are expected to be controversial.

For example, it would protect vaccine manufacturers from liability lawsuits but offer no compensation for individuals who suffered serious reactions to a vaccine.

And states would be responsible for purchasing about 40% of the antiviral stockpile needed to safeguard their residents, which could lead to uneven levels of coverage. Several critics said Tuesday that the $100 million the president would allocate for state preparedness and planning was not enough.

"You can pump billions into vaccine development, but if you don't have the local infrastructure to administer the vaccines, that's a problem," said Dr. Christian Sandrock, a pulmonary and infectious disease specialist at UC Davis Medical Center who is advising California officials on flu preparedness.

Public health experts also expressed concern that the plan would place the Department of Homeland Security -- not the Department of Health and Human Services -- in overall command of the government's response should a pandemic erupt. Homeland Security oversaw the much-criticized federal response to Hurricane Katrina.

"When the emergency occurs," said Kim Elliott, deputy director of the nonprofit, nonpartisan Trust for America's Health, "it would be handed to folks most of whom have not been trained on the public health aspects."

In the case of H5N1, there have been 122 known cases of human infection, virtually all among people who were in close contact with affected birds.

The virus has not developed the ability to pass easily among humans. But if it does, it could kill 2 million to 7.4 million people worldwide, according to World Health Organization estimates.

"A pandemic is a lot like a fire -- a forest fire," Bush said. "If caught early, it might be extinguished with limited damage. If allowed to smolder undetected, it can grow to an inferno that spreads quickly beyond our ability to control it."

Underscoring the seriousness of the threat, two top United Nations officials and six U.S. Cabinet secretaries attended Bush's speech, as did Sen. Edward M. Kennedy of Massachusetts, the ranking Democrat on the Senate health committee.

The Senate has passed an $8-billion flu preparedness plan.

Kennedy called the president's announcement "a long-awaited first step" but said that it needed "to be stronger to ensure that the American people have the protections they deserve." He called for more aid to local hospitals and a vaccine victims compensation fund.

Health and Human Services Secretary Mike Leavitt today will release the details of the flu plan, which took the administration months to prepare.

Leavitt recently returned from a tour of Asian nations hit by the H5N1 virus. In addition to meeting with foreign officials, he visited a family that had caught the virus from chickens but survived thanks to prompt treatment.

Bush said Tuesday that working with other countries was the first step in his three-part pandemic plan. The administration has set up an international partnership, whose 88 member nations have pledged to share information and provide virus samples to the World Health Organization. Bush's plan seeks $251 million -- or 3.5% of the total program -- to help foreign governments track flu viruses and respond to new outbreaks.

Said University of Michigan epidemiologist Dr. Arnold S. Monto: "I would be a supporter of a stronger emphasis on the international problem."

For example, Monto said, paying for widespread vaccinations in Vietnam -- which has the highest number of human H5N1 cases -- could "help extinguish influenza at its source."

The second part of Bush's plan -- and its core -- is a $6-billion effort to purchase vaccines and antiviral drugs and to revolutionize the way vaccines are manufactured. The president set a goal of having enough vaccine for every American.